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City of Edmonds. PERMIT NOON 95i . 9
. PERMIT EXPIRES AUok (i
SIDE SEWER PERMIT V -
Address of Construction: Z,6/0 -)s ,-)41 W LIID#
Property Tax Account Parcel No. 00'q 77!�T - 060 —054P - 00
Attach,.copies of all access and utility easements --o" Verified and Approved b
Owner and/or Contractor: 4,��'AAZ19f /.Z IMI's -ill1c.
Contractor License#: ' 46�wI4 4& S_ 67- 1/ J�4 Building Permit #:
00'Single Family
F] Multi -Family (No. of Units
F] Commercial (No. of Units
Public
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Invasion into City *Right -of Way: El Yes Pq No
W Construction Permit #
Cross dthzr,��Private Property: El Yes No
ion and copy qrecorded easement..
t\ractor
Ow�er' or contractor signature and acknekvledge I ent statement: Da(e
By signing for this permit I certify that I have re d the City's public handout entitled
ide Sewer Specifications, and shall comply wit all City requirements outliii�d therein.
2 CALL DIAL -A -DIG (1-800-4,')-W-5555) BEFORE ANY EXCAVATION 2
.9 FOR INSPECTION I CALL 425-771-0220 extension!_I�-69
24 HOUR NOTICE REOUfAED FOR ALL INSPECTION REOnSTS
"Attach iegal
TOR OFFICE USE ONLY
Permit Fee Repair Fees issued By: UAA/bCLkXZV\
Trunk Charge $ Date Issued: -7)1;�1,0 I
Assessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees Paid $
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO, Date: Initial:,..".-`.
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: Initial: As'-6uilt:td Street File:
1� PERMIT MUST BE POSTED ON'JOB SITEt,
White Copy: File Green Copy: Inspectbr Buff.Copy: Applicant
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CITY OF EDMONDS
SIDE
SEWER AS -BUILT
ADDRESS
18108 73RD AVE W
PERMIT
NUMBER 9519
HOMEOWNER EDWARDS
CONTRACTOR K &
S
CONST,
DATE 08/06/01
DRAWN ISMAEL ABILA
BY
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TOPS 9
33502